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Tamm M.,University of Basel | Chhajed P.N.,Fortis Hiranandani Hospital | Stolz D.,University of Basel
Swiss Medical Weekly | Year: 2010

Bronchoscopic lung volume reduction is a new technology designed to reduce hyperinflation in severe COPD by implantation of endobronchial devices, such as biodegradable material, endobronchial valves or bronchopulmonary stents, via flexible bronchoscopy. This article discusses newest developments and results in bronchoscopic lung volume reduction.

Zade A.,Nueclear Healthcare Ltd | Ahire A.,Jupiter Hospital | Shetty S.,Fortis Hiranandani Hospital | Rai S.,Nueclear Healthcare Ltd | And 3 more authors.
Indian Journal of Nuclear Medicine | Year: 2015

Intramuscular myxoma (IM) is a rare benign neoplasm. In a patient diagnosed with IM of left thigh, we report the utility of a postoperative fluorine-18 fluorodeoxyglucose positronemission tomography-computed tomography scan in assessing the efficacy of surgical excision.

Dalal J.,Center for Cardiac science | Amin P.,Center for Cardiac science | Ansari A.,Lilavati Hospital and Research Center | Bhave A.,Lilavati Hospital and Research Center | And 11 more authors.
Journal of Association of Physicians of India | Year: 2015

Pulmonary embolism (PE) is an important cause of morbidity and mortality among hospitalized patients. Although the exact epidemiology of PE is not known in India, Some of the studies show that more frequently it is missed and not managed appropriately leading to significant cardiovascular morbidity and mortality. Justification and purpose: Indian guidelines for the diagnosis and treatment of acute PE are not yet formulated. The objective of this consensus statement is to propose a diagnostic and management approach for acute PE in India. Process: A working group of 15 experts in the management of acute PE (cardiologists, pulmonologist, haematologist, emergency specialist and intensivists). This consensus statement makes recommendations for diagnosis and management for PE based on literature review, including Indian data. Recommendations: Patients with acute PE should be immediately stratified according to early mortality risk. For risk stratification, clinical parameters, markers of RV dysfunction and myocardial injury should be used. The clinical predictions criteria (Simplified Geneva score and PE rule out criteria) should be routinely used in emergency department. ECG, Chest X-Ray, routine labs, D-Dimer, nt Pro-BNP/ BNP, Troponin I or T, hFABP, echocardiography, lower limb compression ultrasonography (CUS), CT-pulmonary angiography, ventilation- perfusion scintigraphy (V/Q scan), and pulmonary angiography should selected in suspected cases of PE as per risk stratification. Anticoagulation should be immediately started in high or intermediate clinical probability of PE during ongoing diagnostic workup. In high risk PE, anticoagulation with UFH should be started without delay. Initial treatment with unfractioned heparin, LMWH or fondaparinux should be continued for at least 5 days and may be replaced by vitamin K antagonists only when target INR levels for ≥ 2 consecutive days is achieved. Thrombolytic therapy is recommended in all patients with high risk PE, unless contraindicated. Routine use of thrombolytics in non-high risk PE is not recommended but may be considered in selected cases with intermediate-risk PE. Thrombolytic therapy is not recommended in patients with low risk PE. Anticoagulation should be given for at least 3 months. Need for longer duration should be reevaluated after risk-to-benefit evaluation at that time. Recurrence is common; hence long-term anti-coagulation may be required in selected cases. Pulmonary embolism response team (PERT) composed of specialists in various fields has been suggested. © 2015, Journal of Association of Physicians of India. All rights reserved.

Sandeepa H.S.,Fortis Hiranandani Hospital | Kate A.H.,Fortis Hiranandani Hospital | Chaudhari P.,Fortis Hiranandani Hospital | Chavan V.,Fortis Hiranandani Hospital | And 3 more authors.
Journal of Cancer Research and Therapeutics | Year: 2013

This is a case report of a young adult presenting with hemorrhagic pleural effusion. Chest CT scan showed loculated pleural effusion with pleural nodule. Whole body PET scan showed thickening of pleura with multiple enhancing pleural nodules with different metabolic activity. Pleural nodule was biopsied which on histopathology showed pleural synovial sarcoma.

Chhajed P.N.,Fortis Hiranandani Hospital | Chhajed P.N.,Institute of Pulmonology | Chaudhari P.,Fortis Hiranandani Hospital | Chaudhari P.,Institute of Pulmonology | And 7 more authors.
Scandinavian Journal of Clinical and Laboratory Investigation | Year: 2012

Background. Transcutaneous measurement of carbon dioxide is routinely done at the earlobe site. In patients receiving non invasive ventilation or in the intensive care setting with necklines, an alternate measurement site would be useful. We started to use the infraclavicular site for transcutaneous measurements of carbon dioxide using a new digital sensor. Aim. Comparison of transcutaneous carbon dioxide with arterial carbon dioxide at the infraclavicular site. Methods. We retrospectively compared transcutaneous carbon dioxide at the infraclavicular site with arterial carbon dioxide in 50 samples. The Sentec Digital Monitoring System (Sentec AG, Therwil, Switzerland) was used. The V-Sign digital sensor was placed on the infraclavicular site at the medial two third and one third point from the sternoclavicular joint and acromioclavicular joint. Results. When comparing PcCO2 with PaCO2 values, the Bland-Altman analysis revealed a bias of 0.02 kPa (95% CI: [- 0.1; 0.14]) with a precision of 0.42 kPa. Linear regression analysis describes the relationship between the two methods. The slope of the linear model was 0.85±0.04 and the intercept was 0.77±0.21 (RSE=0.37 ,R2=0.91). Conclusion. The measurement of transcutaneous carbon dioxide at the infraclavicular site is feasible with a digital sensor and has a good correlation with the carbon dioxide values obtained from the arterial blood gas. The findings of the current study form the basis for further clinical studies for its regular application in clinical use. © 2012 Informa Healthcare.

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